Inflammatory biomarkers and decline in kidney function in the elderly: the Cardiovascular Health Study
Open Access
- 3 September 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in Nephrology Dialysis Transplantation
- Vol. 25 (1), 119-124
- https://doi.org/10.1093/ndt/gfp429
Abstract
Background. Cross-sectional studies have demonstrated a consistent and linear association between circulating inflammatory markers and kidney function. The objective of this study was to determine whether elevated markers of inflammation are independently associated with longitudinal kidney function decline. Methods. This study included 4128 subjects from the Cardiovascular Health Study. Cystatin C was measured at baseline, 3 years later and 7 years later; eligible subjects had at least two measures. Cystatin C-based estimated glomerular filtration rate (eGFR cysC ) was estimated, and rapid kidney function decline was defined as an annual loss of eGFR cysC> 3 mL/min/1.73 m 2 . Predictors included ten inflammatory and procoagulant biomarkers: C-reactive protein, interleukin-6, intercellular adhesion molecule-1, white blood cell count, fibrinogen, factor VII, factor VIII, D-dimer, plasmin-antiplasmin complex and serum albumin. Results. During the study, 1059 subjects (26%) had a rapid decline in kidney function. In contrast to the other nine inflammatory or procoagulant biomarkers, serum albumin had a consistent and inverse association with rapid kidney function decline [final adjusted logistic regression model: 1.14-fold increased odds (95% CI 1.06–1.23) of rapid decline per standard deviation lower albumin]. The lowest quartile of albumin had an odds ratio of 1.55 (95% CI 1.23–1.96) for rapid decline compared with the highest quartile. These associations persisted after adjusting the albumin models for CRP, IL-6 and fibrinogen. Conclusions. In contrast to nine other inflammatory and procoagulant markers, only lower baseline levels of serum albumin were consistently associated with a rapid decline in kidney function, as measured by cystatin C-based eGFR.Keywords
This publication has 27 references indexed in Scilit:
- Estimating GFR Using Serum Cystatin C Alone and in Combination With Serum Creatinine: A Pooled Analysis of 3,418 Individuals With CKDAmerican Journal of Kidney Diseases, 2008
- Kidney function and markers of inflammation in elderly persons without chronic kidney disease: The health, aging, and body composition studyKidney International, 2007
- Soluble intracellular adhesion molecule‐1 is associated with cardiovascular disease risk and mortality in older adultsJournal of Thrombosis and Haemostasis, 2005
- C-Reactive Protein and the 10-Year Incidence of Coronary Heart Disease in Older Men and WomenCirculation, 2005
- Biomarkers of inflammation and progression of chronickidney diseaseKidney International, 2005
- Definition and classification of chronic kidney disease: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)Kidney International, 2005
- C-Reactive Protein, Interleukin-6, and Fibrinogen as Predictors of Coronary Heart DiseaseArteriosclerosis, Thrombosis, and Vascular Biology, 2003
- Serum C-reactive protein and leptin as predictors of kidney disease progression in the Modification of Diet in Renal Disease StudyKidney International, 2002
- Fibrinolytic Activation Markers Predict Myocardial Infarction in the ElderlyArteriosclerosis, Thrombosis, and Vascular Biology, 1999
- Evaluation of the Dade Behring N Latex Cystatin C assay on the Dade Behring Nephelometer II SystemScandinavian Journal of Clinical and Laboratory Investigation, 1999